NPIMap

Organization Active NPI

Adventhealth Imaging Training Center

  • Clinic/Center
  • Orlando, FL
National Provider Identifier
1649916594
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ADVENTHEALTH IMAGING TRAINING CENTER
Practice address
25 South Terry Ave
Ste 220
Orlando, FL 32805
Phone
(407) 641-2446
Fax
(407) 641-2447
NPI assigned
May 12, 2022
Last updated
May 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Mazeres
Title
VP/Cfo
Phone
(407) 200-2227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

25 South Terry Ave
Ste 220
Orlando, FL 32805

Mailing address

25 South Terry Ave
Ste 220
Orlando, FL 32805
Phone (407) 641-2446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721001414 FL Part B Supplier - Clinic/Group Practice 1254311137 Receives reassigned benefits from 420 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orlando, FL; Oviedo, FL; Palm Beach Gardens, FL; Parkland, FL; Port Orange, FL; Vero Beach, FL; Weston, FL; Wilton Manors, FL…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2257596Adventhealth Imaging Training Center25 South Terry Avenue Suite 220, Orlando, FL 32805Certificate of waiverApr 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Adventhealth Imaging Center Port Orange12 organizations share this tax ID, including this one
Part of
Adventhealth Imaging Center Port Orange

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25 S Terry Ave
Ste 220
Orlando, FL 32805
Phone (407) 641-2446

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1649916594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 SOUTH TERRY AVE",
            "address_2": "STE 220",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32805",
            "telephone_number": "407-641-2446",
            "fax_number": "407-641-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SOUTH TERRY AVE",
            "address_2": "STE 220",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32805",
            "telephone_number": "407-641-2446",
            "fax_number": "407-641-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTHEALTH IMAGING TRAINING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA RADIOLOGY IMAGING AT LAKE MARY LLC",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "MAZERES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "407-200-2227"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.